Sex Differences in Smoking Cessation Pharmacotherapy Comparative Efficacy: A Network Meta-analysis
Philip H Smith1,2,3, Andrea H Weinberger4,5, Ju Zhang6
1Community Health and Social Medicine, Sophie Davis School of Biomedical Education/CUNY School of Medicine, New York, NY.
Summary
Varenicline is more effective for women than men in smoking cessation compared to nicotine patches and bupropion. Clinicians should consider varenicline as a first-line treatment for women seeking to quit smoking.
Area of Science:
- Pharmacology
- Addiction Medicine
- Public Health
Background:
- Sex-specific differences in treatment efficacy are increasingly recognized in pharmacological interventions.
- Smoking cessation pharmacotherapy efficacy may vary between men and women.
Purpose of the Study:
- To compare the efficacy of transdermal nicotine (TN), varenicline, and sustained-release (SR) bupropion for smoking cessation.
- To investigate potential sex differences in the comparative effectiveness of these smoking cessation medications.
Main Methods:
- Network meta-analyses of randomized, double-blind, placebo-controlled trials.
- Inclusion of studies on bupropion-SR, TN, and varenicline for smoking cessation.
- Analysis of data from 14,389 smokers, with 51% being female.
Main Results:
- Varenicline demonstrated greater efficacy than TN and bupropion for women.
- For men, varenicline showed similar outcomes compared to TN and bupropion.
- All tested medications improved quit rates compared to placebo for both sexes.
Conclusions:
- Varenicline offers a significant advantage over bupropion SR and TN for women's smoking cessation.
- Varenicline is recommended as a first-line treatment option for women.
- The comparative advantage of varenicline over TN or bupropion is less pronounced in men.
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